Things You Learn in Therapy
Things You Learn in Therapy
Ep122: Unlocking Effective Clinical Supervision: Insights from Michele Mani
Unlock the secrets of effective clinical supervision with insights from Dr. Beth Trammell and her esteemed guest, Michele Mani, a seasoned clinical supervisor and psychotherapist. Michele shares her journey from clinical practice to private practice, and how it has elevated her role in supervision. Together, we explore the art of balancing professional duties with personal wellness, as exemplified through our mutual love for sports—Michele with pickleball and me with tennis. This episode promises to offer listeners valuable lessons on maintaining harmony between work and self-care.
We dive into the essential qualities that define a great supervisor, underscoring the importance of presence, punctuality, and attentiveness. Drawing from personal anecdotes and feedback, we address the realities and challenges of managing both administrative and clinical responsibilities. We discuss how cultivating a culture of feedback and engagement fosters an environment ripe for growth and respect. Through our conversation, we aim to inspire supervisors to become the mentors they aspire to be, creating supportive spaces that encourage development and reflection.
Through practical strategies, we offer guidance on nurturing independence while providing necessary support to supervisees. We focus on establishing clear communication expectations, emphasizing the value of supervision journals and personalized attention. Navigating the complexities of supervising early-career therapists, we highlight the importance of a supportive team environment and regular consultation with peers. This episode serves as a comprehensive guide for supervisors seeking to enrich their practice, helping them understand the best practices to overcome challenges and build a nurturing supervisory relationship.
This podcast is meant to be a resource for the general public, as well as fellow therapists/psychologists. It is NOT meant to replace the meaningful work of individual or family therapy. Please seek professional help in your area if you are struggling. #breakthestigma #makewordsmatter #thingsyoulearnintherapy #thingsyoulearnintherapypodcast
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www.bethtrammell.com
Hello, welcome back, listener.
Speaker 1:I'm your host, dr Beth Trammell, and I'm a psychologist and a professor of psychology at Indiana University East, where I also am the director of the Master's of Mental Health Counseling Program.
Speaker 1:And the topic for today actually comes from the work that I do at the university, but also some of the work that I have done personally around supervision and, I think, the role of supervisor. I don't know, I think it's complicated because I think we might, as clinicians, think, oh yeah, I want to supervise someone, but without real training and without real intention, the work of supervision can be really hard. Frankly, the work of supervision is really hard even without all of those things. But to be a good supervisor, I think it takes a lot of work and it's a lot of awareness and a lot of kind of realizing, perhaps, some of the pitfalls of supervision. And so, when I was thinking who could I invite to talk about supervision, there is only one name on the list for me and it is my dear friend, michelle. So, michelle, can you introduce yourself to listeners and tell us one fun thing about you?
Speaker 2:Okay, sure, thank you. What a wonderful introduction.
Speaker 1:Thank you for your warm invitation and intro what a great person you are, so I'm just glad you're here.
Speaker 2:Oh, my goodness, sending twinkles. Okay, so my name is Michelle Manny and I'm a clinical supervisor, registered psychotherapist and Canadian certified counselor. I am located in Ontario, canada. It is just a pleasure to be back here with your lovely audience. I would say right now about 70% of my practice is clinical supervision and I do it in private practice, which is interesting for me because when I left my initial field I was working in EAP and other areas To move into private practice, I hadn't anticipated necessarily that clinical supervision was going to take as much of a larger role as it has. My roles before were in clinical supervision as well, but the desire for clinical supervision, both in terms of registration as well as across the career span, I think has really expanded, which is wonderful and lovely to see. Yeah, so that's more. That's me.
Speaker 1:Is that your fun thing, or do you have a fun thing that?
Speaker 2:is fun. I actually really do. It is fun. I really really do enjoy it. I would say my fun thing recently I give you two words or one word together pickleball. So it is fun. I'm having a bit of a challenge because where I'm located now on the Georgian Bay has drop-in pickleball like five, six days a week during the day. So if you're working during the day it's been a bit of a challenge to find people or the time for that. But the few times I'm able to get out and I find myself playing with people in their late 60s, 70s and 80s, they are killing it. They are killing it. They are killing it. They are much better than me, but I'm having a good time and hope to find some more evening spots there. So that's it. Pick a ball.
Speaker 1:That is so fun. It is fun. My parents have been, you know, avid picklers for a while and they kind of introduced me to the game a little while ago and but honestly, I have started taking up tennis for kind of, and I kind of have a similar thing, except I canceled daytime appointments to make sure I can get to tennis yeah, I think there's a learning here for me, you know, I'm not sure, I don't know, because I just value it so much and that it gets me to move my body.
Speaker 1:And there's this community of people that also play and it fills my whole cup for the whole week to just play one time on a Friday morning. Thank you for that.
Speaker 2:I need to take that away. I'm going to take that away because it is really important. I remember I used to work with a supervisee who was out west in BC and we were trying to schedule something and she was like, oh yeah, no, I don't work Thursdays. And I was like, oh okay. And she's like, no, that's my ski day. I was like, oh okay. So so she had already put aside specific days for her British Columbia skiing and then that was it. That was a priority. So that kind of reminds me of that.
Speaker 1:Well, you know, it's interesting because earlier today I recorded another episode where we were talking about how we tend to be great at sharing ideas with clients as therapists, you know, and we're like you really need to prioritize your self care and prioritize your own mental wellness and schedule things on your calendar that matter and I'm like, well crap, I probably should do that crap. That's actually pretty good advice and I got to do that. So I've been doing it for I don't know a year and a half now and I really, single week, look forward to that time with my friends and playing tennis and the challenge of learning something new when you are 43, you know I support you, you know thank you.
Speaker 2:So shout out to my supervisees Wednesday mornings I will be offline. I'm sure available in some way. That's okay. Find a backup supervisor, let's get into it. But okay, I'll find a backup supervisor.
Speaker 1:It's great. It's great, Okay, yeah. So you know, at the beginning of the show here I introduced this idea that I'm not sure everybody who goes into being a supervisor realizes the burden of supervision. Would you say that's true or do you think that's just sort of something that I think your thoughts are?
Speaker 2:valid. I just want to validate that first. Your thoughts are valid. So first of all, I'm wondering about the change of supervision overall and the development and recognition of supervision overall over the years. And I'm also wondering about some changes overall over the years, and I'm also wondering about some changes, perhaps even differences, between Canada and the States. And so when I think about the development supervision, it's always been recognized as something important to do and certainly something we need to do for our licensing. But I really think it's in the past five or 10 years that it's become even more highlighted and recognized, both in in research and the number of people going into it as a profession, that it is a standalone profession. I'm certainly not suggesting that this wasn't the case 10 years ago, but there has been an important movement into the recognition of it from a broader perspective, even outside of academia or outside of the supervisors themselves. And so this idea that it becomes part of the career span, which is something not just spoken about as, yes, it's important to stay in supervision, but really understood and followed up by clinicians, I think is a little bit newer in the past decade and developed and it's really nice to see that developed and see it as a again that standalone profession.
Speaker 2:So back to your question. I'm thinking in the past supervisors often got volunteered or right, like in quotations volunteered or promoted to supervisor. They'd be working in a location maybe it's a clinic, maybe it's a school, maybe it's an EAP, environment group practice and they're doing well after a few years and they get promoted. Now you're a supervisor and I think that, although that still happens, there is something that has changed with expectations with regards to training and that that connects with the increase of understanding and recognition of supervision as standalone.
Speaker 2:So I'm certainly not going to speak for an entire country or even province, or even city, but what I will say is that I have noticed a difference where I am located, where people would go into supervision for a variety of reasons, but now something feels to have shifted, that it's recognized as kind of like an alternative working position, right, like a different option in the clinical world, and so the same way that people might be thinking about do I want to develop courses? Do I want to go into private practice? Do I want to provide options to my clients? They're now thinking, oh, do I want to become a supervisor? Because it becomes one of many different options available to them. I'm certainly not saying they're not invested in it or interested in it available to them. I'm certainly not saying they're not invested in it or interested in it, but they're taking a different direction towards it than I've noticed in the past few decades.
Speaker 1:Yeah, I think at least my experiences around here in Indiana it's sort of I think it's still you're voluntold to be a supervisor. You know that it's just you've just moved up and now you're supervising, but you don't have any kind of certification or specialized training. And then I think there are people who it's more like an add on to the license that they have, so they might be doing these specialized trainings and now they're they specialize in supervision. I'm not aware of the movement, at least again in Indiana, to move toward having supervision throughout your career.
Speaker 1:We tend to think about it through the lens of consultation and so we call it consultation, even though it is very similar to the work of supervisor, just minus the hierarchy and the responsibility, yeah.
Speaker 2:So I'm just like I'm getting excited just talking about this and I'm thinking I can talk about this for like two hours. So I'm going to hold myself back because your listeners do not need to listen to me talk for two hours about the differences between consultation and supervision and responsibilities involved, like so I'm going to. I'm going to calm myself down right now. Don't, don't calm yourself, get excited calming myself because we have so much to talk about well, where do you want to go next then?
Speaker 2:perhaps I just want to recognize, if we close that piece, I just want to recognize that you know certainly I'm not saying in canada that everybody is like, oh, I've been practicing for 10 years, am I attending my weekly supervision there? You know, that's not what's happening. People are accessing either peer support or consultation, but there does seem to be a movement in integrating that as part of one's regular practice. So, for example, I attend I both provide group supervision to a number of therapists in different areas of their growth, from qualifying to very experienced. So I provide group supervision to those and I also attend group supervision, which is a wonderful experience with me, with a series of experienced therapists from different backgrounds with a wonderful supervisor. So I do think that we're starting to see not just speaking about the important points but actually accessing the support community. That's important for us. Yeah.
Speaker 1:And I think we don't do it enough. I mean, I think that's true. I think most therapists would say, especially those in private practice, even those in group practices still feel like it's a very isolating profession, will continue to live with for a while and then maybe, if it gets to a point, they may reach out for supervision or consultation. But I don't know. I think maybe you're right that it's growing and popularity is not the right word, but it's growing in like I think the practice is growing.
Speaker 2:I think the recognition of it being an important element is we're not just giving lip service to it, like, again, I'm looking outside of academia. An important element is not we're not just giving lip service to it, like again outside, where I'm looking outside of academia and um, uh and outside of uh, outside of licensing or licensure right, and I'm seeing people who have completed licensing, licensure, or have uh, uh, accessed um independent practice from their colleges still continuing with it, whereas before it was more moving directly into consultation. But I do want to address something that you said when you were talking about do people? Okay, we're going to, we're going to circle back here.
Speaker 1:Yeah, great.
Speaker 2:You know, do people realize the burden of it, and so what I would say is that, or I would offer, is that I think it's like anything else some people recognize, some people are seeing it as an add-on and some people are passionate about it, just like any position, right? Yeah, sure, some people are passionate about it. Some people recognize or learn the, the level of work that comes into this and the level of specialization. Some people may start and find that it's not for them and some people may come in as an add-on and then they find out that they're really passionate about it and they want to kind of support the growth in other therapists and that's something they're very committed to because it does take additional work. I would also highlight that what I do see as a movement and again I can only speak in Canada is towards I wouldn't say licensing per se, but is towards requiring certain trainings for supervision. And when I look at different countries, I'm not even thinking about the States, but if I look for the UK, I don't know what that's like. I'm not even thinking about the States, but if I look for the UK, I don't know what that's like.
Speaker 2:Certainly, in Canada, at different times, you were able to be a supervisor without accessing certain training, Whereas now that has again in the past years that has changed.
Speaker 2:So, for example, if you're a member of the CRPO, the College of Registered Psychotherapists in Ontario, although you don't have an approved supervisor, you can't be like an approved CRPO supervisor.
Speaker 2:But to be a supervisor where qualifying therapists get their hours signed off, you have to meet certain criteria. So it's not that the CRPO comes and says, well, we're going to approve you, you and you, but to actually be able to sign off on your supervisees hours, so they've graduated, they've done their practicum and now they're practicing out of a qualified status and they're working towards independent status, so they have to access a certain number of supervision hours to be able to move into independent practice. To be able to sign off on those hours, you must meet certain criteria and part of that criteria is some type of training and supervision. So is there the potential for it to become I don't know more detailed or more hours? Certainly, Does every college or association do it the same? No, but that's an example of somewhere where you do need specific training and supervision in addition to having practiced at least five years, in addition to other qualifications, having the independent license on your own too.
Speaker 1:Yes, yes, exactly, exactly, okay, so put you on the spot.
Speaker 2:All right, put me on the spot, ready for that.
Speaker 1:What would be on the list must be qualities for a great supervisor.
Speaker 2:Okay, that is a very good question.
Speaker 1:And my other very good question you actually asked before we started recording how can I be the supervisor I always wanted, right? I mean, I think that that's at the heart of what maybe every supervisor will want to maybe work toward or achieve. But if I think about some of my own great supervisors, it was like certain things about them and I'm trying to put into like what, what are some of those things? And so I don't know. I want to hear your list and then maybe I'll share mine, so let me frame this by saying what I'm going to stay away from for this conversation.
Speaker 2:okay, so I'm going to stay away from supervision models. Okay, okay, so I'm going to stay away from supervision models.
Speaker 2:Okay, because there's lots of. There's many different models that we could talk about what they focus on. So I'm not going to focus on the supervision models Okay. I am going to reflect on my experiences and my supervisor colleagues' experiences, as well as feedback that I've gotten from supervisees over the years. So this may seem very elementary but I would say, even from step one, showing up as a client, you want your therapist to show up, as a supervisee, you want your supervisor to show up, and so that means it sounds very basic, but I have met with a number of supervisees. I always kind of explore what positive experiences have they had. Many have had fantastic experiences. Which experience have they had that maybe wasn't the best fit for them, just like we do with clients. And so even from like the very first moment, supervisors showing up when they say they will, moment supervisors showing up when they say they will, prioritizing that time with their supervisees and respecting the time of their supervisees yeah, and where that might look different and maybe we'll get to this later, maybe not where that might look different is according to the environment of the supervisor and supervisees.
Speaker 2:So if a supervisor has a dual role of admin supervision administrative supervision and clinical supervision.
Speaker 2:Sometimes there could be conflict between the two or time restraints between the two, and so you can find somebody that were supposed to sit down, have clinical supervision but these other mandated uh requirements or priorities or business priorities came up, organizational priorities came up, and so then it gets addressed there.
Speaker 2:Or you can find in and maybe you could speak to this more you can find in certain academic institutions if someone's doing their master's or their doctorate in counseling, et cetera, and the supervisor, who may be a professor, who may be a director, the supervisor who is meeting with the clinician, maybe the practicum student may be overloaded, may not have the time required, may have from their organization too many things on the go, yep, their fingers in too many pies because that's what the organization is requiring of them and so they don't have as much time. Or it could just be, you know, just like anybody else in any profession, not prioritizing that. So showing up, when we say we're going to show up, being on time, making a priority and having that space protected, I would argue, even if we do administrative and clinical supervision at the same time, when I say we may get to that later, there is a dual role. How do we make sure that we are prioritizing our time to carve out time and attention for this important practice?
Speaker 1:You're right, it couldn't be simpler. But I know, sending off the vibe that I am fully attentive and I don't have any other things pressing right Like I can imagine, I can think about moments where, you know, my supervisee was like well, I don't really have much else to talk about and I'm like all right, you know. Instead of like really prioritizing that time, knowing there are so many things that I should be developing in them in just that one hour a week that if they didn't come with enough to fill the hour, I should have pressed additional ways to help them grow and so the idea of showing up and prioritizing that time and like making sure you respect the time but really prioritize it, I think is a great place to start.
Speaker 2:Yeah, but you're showing up, you're showing up, right. So I've talked with supervisees. Where you know supervisees will get just like clients will give us, will give us a little rope, like they'll give us a little bandwidth, right. So we have to cancel once they understand we're late, once they understand we're late five times, right, so we have to cancel once they understand we're late, once they understand we're late five times, we're late six times, we're consistently canceling, we're reducing the time. They notice very quickly and they're also in a more vulnerable position. And I would say that in some ways, probably private practice supervision is a little bit different because we're being paid directly and so, just with a client, you know we're showing up, we're showing up on time and for the full amount of time, whereas it could be more difficult when you're in different rules. Although, having said that, even in private practice, just like with counselors, not all counselors show up the same way and not all supervisors show up the same way you know one thing that I think about.
Speaker 1:You know, at the beginning you asked this question like how can I be the supervisor I always wanted? You know one thing that I think about with my own experience, you know, I had supervision at the master's level and then I had supervision at the doctoral level and I was a student who really well in over my head and people pleasing, and so I would show up to supervision and often present in ways that I thought would please my supervisor and because I think I generally showed up and appeared like I had it sorted together, maybe in comparison to I don't know, I have no idea, but I just don't remember getting a lot of feedback. I think they gave me some ideas to work on clinically, but I don't remember like a regular culture of feedback and I have. I'm a huge fan of the Thanks for the Feedback book by Douglas Stone and Sheila Heen. I've got it on my bookshelf back there. But that really helped me as a supervisor to give feedback.
Speaker 1:Well, teaching, like how people receive feedback, but I don't think I got a lot ongoing. They just thought, well, she's doing okay, she's showing up, she's doing just fine, she's seeing her clients, what she's telling me sounds about right. Otherwise it was like, well, everything's fine, and so I try really hard to like give it's a real skill. It's. It is kind of a rare skill I'm learning.
Speaker 2:It's a real skill to give feedback. Well, I mean, I'm still learning. It's a real skill and it's also, depending on where, right. And I really like how you brought that in, because when you're thinking, how can I be the supervisor I always wanted you were the supervisee, that was like, yeah, I'm showing up in this way, but I need feedback. Yeah, I need feedback. And so you created, you know, you integrated in your role how do I be the supervisor I wanted into a supervisor who does provide feedback, effective, helpful feedback in a way that's more likely that clinicians are going to be able to take in in non-defensive ways. And that's hard to do and it's scary to do.
Speaker 1:Yeah, and I'm not sure I'm doing it well all the time. But I make my graduate students read this book and then we kind of go through it together and recognize the things that like keep us from receiving feedback. And then you know I'm just rambling now, michelle, but you might want to take the mic back.
Speaker 1:But sometimes I'm like as a professor and I find this to be true when I talk to other colleagues too about this that I want my students to reach out. I want my supervisees to reach out if they're struggling, but I also need them to figure it out on their own some of the time so that they can build some of their own like competence and emotional resilience and being able to tolerate, like some hard things. And so I sometimes find it hard to balance, like how do I communicate? I want you to reach out for support, but also there's going to be so many things that you are going to have to kind of work through some pieces on your own. I'm a bad. That is such a good. I'm just a bad supervisor, michelle you are wonderful?
Speaker 2:No, you are. I can tell you're a wonderful supervisor. I really like that. I think that's our third point we could come to. I'm going to go back to our second point, so the second point you brought up was feedback.
Speaker 2:Yeah, so I would say that absolutely essential for an effective supervisor is giving an eliciting effective feedback and eliciting from the supervisee effective feedback. So there's lots of tools that people could use, right. There's tools, there's forms you can ask your supervisees to complete. There's like feedback, informed treatment right for for super, for supervisors and supervisees. There's rating sales that you can provide them. So there's all sorts of tools that are available. But just having the environment where, like intentional, and creating an intentional environment where therapists are more likely than not to give you feedback, seems really relevant and important. So I think the research supports how much supervisees don't share or keep back from their supervisors.
Speaker 2:Yeah, right, right, and I know when I was working in a company and when I was working in an environment where I was an employee, you know, half the time you were thinking what do you think is going on? We're like we have no idea what's going on, and sometimes we did because there were certain data points. More than being in private practice, for sure, or even in a group practice, there were certain data points we were able to see and there was feedback from clients that we were able to elicit, which people typically do not necessarily do from an organizational perspective, if you're in private practice or in a group practice, so if you're in a company, you're eliciting, you're sending clients those feedback forms, if you have consent, there's a, there's a complaints process that gets attended to. That's really highly structured. So there are some different feedback pieces that are structurally inherent in that organization where there are data points. But at the same time, sometimes you're like what is actually happening, right, we don't know. And so the research shows that supervisees are we're not going to be surprised to hear this that supervisees are we're not going to be surprised to hear this are not always completely transparent with their supervisors, including if they think they've made a mistake Like sometimes it's a big enough mistake they might have to bring it forward. But if they think that they've made a mistake or if they're concerned about something, they're not always coming forward, not always coming forward.
Speaker 2:And so I try to take research and use it in a way that's applicable for me and my clients and my supervisees. I go into it with supervisees. I go into it with the knowledge that they will often hold things back, either intentionally or sometimes very unintentionally. So if I go in with that lens. I want to create an environment where it is more likely than not that if there's an area where they are embarrassed or there is an element of shame or they're not sure what to do on those elements, that they will reach out. So maybe not all the time, but I want to create an environment built into that that we've had different types of conversations about different types of things, so that they can take that risk with me. Does that make sense?
Speaker 1:Yes, I'm thinking about how many supervisees you have. And then how do you say you can come to me with this?
Speaker 2:but then also, like you can't call me every other day, like I can't afford, right, so that comes back to the balance piece right, just yeah yeah, and let's, let's go into that, but I just wanted to close this piece about when we're talking about the feedback yeah, it's not just feedback from us to our clinicians, it's feedback from them to us, because that helps, informs it, and I have had.
Speaker 2:I still know that some of my supervisees don't bring certain things. If there's a very big problem, they will come typically Right, so that's great, but sometimes if something's fallen off and they're embarrassed or feelings of embarrassment or shame, I've had the privilege where they have said I am so uncomfortable and anxious to talk to you about this and they've told me about, like, what the issue is, and so I become really, really intentional about my reaction to them Okay, I love this.
Speaker 1:Okay, we're going to stay here and then we're going to come back to this balance thing. That's what you're saying.
Speaker 2:No, no, that's it, that's it no.
Speaker 1:I have one more question, okay. Okay, okay, okay so so do you sort of explicitly say in supervision right that like, hey, there's going to be times where you're not going to want to tell me the things that, like, you're afraid I'm going to be upset about? Or like, do you set that almost like part of the informed consent process, that is, so funny that you say this, because listening to that I think to myself.
Speaker 2:I tend to be pretty explicit, but I don't know if I'm that explicit with every supervisee at the front end.
Speaker 1:I am with clients, yeah yeah, for sure I am with clients.
Speaker 2:I am with clients, explicit on the front end with that, about how I want their feedback and how no feedback is bad feedback and all their feedback is good feedback because it helps me know where they're coming from and it helps us move together more in the direction that's preferred for them. Blah, blah, blah. I don't know. I think it would be a great idea. Now, of course, like, am I a good supervisor? Like I think that of course makes complete sense. But to be fully transparent, I don't do that all from the onset.
Speaker 2:I try to show now I might do that, but I try to show from our interactions that not wanting to overuse, to use an overused expression, but to create a safe space. So what I do ask them is I do frequently ask the supervisees for feedback. How is this? You know how are sessions going? Are we talking about what's important to you? Is there something we haven't really talked about today or touched on? Are we focusing on what's most important to you? But that idea of sometimes you will not want to bring things to me, I may start integrating.
Speaker 1:Okay so this is interesting. I mean I'm thinking okay, so your supervisees, like you're getting paid directly for that service from the supervisee, most of them.
Speaker 2:Some of them from their practice, like some of them, if they're in a group practice and they need to access external supervision. Some of them from the practice, but let me think for a moment most of them from the supervisees directly for external supervision.
Speaker 1:Yeah, okay. The supervisees directly for external supervision? Yeah, okay, so they may be more motivated to stick around the whole hour or like the whole time allotted for supervision each week.
Speaker 1:They absolutely do. Yeah, and cause, cause? My other question was thinking about like specific questions that I could ask as a supervisor that might elicit more information, or like let them know that I'm open to hearing about any mistakes or anything that like could have gone wrong, sort of things, in those moments when, like, my supervisees are like well, it's minute 38 and this is part of our class and I have to be here. This is part of our class and I have to be here, but nobody's paying more or less or getting paid more or less, so I'm thinking like, but I can still see that Sometimes.
Speaker 2:I will still see that that will come in another part, either in this session or another another session together.
Speaker 2:I will still see that with private. With private, will you? Okay, yeah, and that's a challenge, because some supervisees will come always with something to talk about prepared, or even if they don't come with a particular case in mind within two minutes, we're into it. Yep, they're reflecting, they're exploring that Right. Part of my responsibility is to help them develop that reflection. But even though they're paying for it, they need to get their hours. So there's not, it's not that every supervisee is coming with the same level of commitment to that process, if that makes sense in a non-critical way.
Speaker 2:But that's something I've had to learn because I have made assumptions and then they've gotten in my way, but that's another topic. So, okay, make an environment where they can tell you things.
Speaker 1:Yes and show them through behavior.
Speaker 2:Yeah, okay, so let's go to. How do you balance supervisees to reach out for support, but also to develop the skills to work on their own?
Speaker 1:Yeah, what would you say? Shit, I'm trying to figure it out. That's why you're here. You're the expert. No, I'm trying to figure it out. That's why you're here. You're the expert. No, I, I I'm not sure that. I. I'm not sure I always do this. Well, you know, I think I have tried to sort of gently ask them to pause and consider what's happening, but I'm not sure I always have done this well that I haven't been like okay, so just take a breath and think it through before you reach out and text or call, or obviously, if it's a crisis, then obviously call right away. But if this is like your own struggle and it feels like you're having a meltdown, but it's not actually like a client crisis, then I want you just to sort of like try to breathe through it a little bit and then we can talk about it next week. But I don't know, michelle, I'm not, I don't know if I'm great at this.
Speaker 2:I think these are all skills that we're all developing and I imagine that it really depends on where they are in their career and in their development as a therapist. Because depends on where they are in their career and in their development as a therapist, because I don't see that a lot. I don't see that a lot Now, partly it may be because they think I'm going to take up Michelle's time, I'm going to have to pay for her. I don't want to pay for her, I'm not going to reach out, but if they've been working with me long enough, they know that's not the case. Like, I always tell a group and I'll always tell my supervisees. If you need anything in between, just let me know. And overall they're very, very respectful of that. So if they have a quick question, like, they'll be in touch with me, or if they need an additional consultation, they'll be in touch with me.
Speaker 2:I'm more concerned of, like, how can things not be showing up? So, like, where are they? It comes back to that when are they? So for me, maybe we're we're with different populations sometimes, like for for my students, um, sometimes I'll do external supervision with students, yeah, like, so I'm thinking about my student now, like we stay in more close contact online than, let's say, with somebody who I'm seeing, you know, weekly. They're already in qualifying status, they've already been practicing for a while, yeah, um, and are working towards independence post-graduation um. So so my student and I are in more contact, like online, like I'll see an article that'll be interesting or a podcast, I'll send it to her.
Speaker 2:Uh, she's very engaged, so she'll be like oh, I listened to it, I thought about this and that and that, or I want you know, oh, I'm not quite, not quite sure what to do about this or, but she's choosing I guess this is part of the assessment, right, she's choosing the right times to ask me questions. So things where things that are coming up that she's not sure about, she's actually choosing those are the right times to come to me. I want her to come to me for those things and I haven't had the experience yet. If she's listening right now I'm not saying your name, okay, nobody knows, nobody knows, it's you, it's all good stuff, but when I'm thinking about her, she is coming with what I would consider appropriate.
Speaker 2:Like I've told, I do want her to come with me because it's much easier to deal with an issue in the moment rather than to deal with it after it's happened and there's been fallout. So I haven't had the situation yet with her where she's come with a situation that I really should know about so that we could talk it out and come up with a solution and then come back with the same thing, and then come back with the same thing. That hasn't happened yet with her. So I'm interested Is that happening with your students? Like, are they coming with things that you've already reviewed with them before? Are they coming with things that aren't necessary in between sessions?
Speaker 1:At the heart of kind of my curiosity around this topic is like it's clear that the burden to clarify this is on me, that I need to clarify this would be a moment where I need you to reach out to me. This is the moment where it feels uncomfortable for you and you want somebody to talk through with you, but that's not the moment to call me outside of our regularly scheduled supervision time. Right?
Speaker 2:Sometimes I do that. I'm pretty explicit with students about that yeah, not with the other ones, but I'm explicit with students. I go listen. So if something comes up around safety concerns, I want to know and then I explain what that is. It can be safety, it can be suicidal ideation, it can be risk session with somebody and you're feeling completely over activated or dysregulated. Reach out. We can debrief that together.
Speaker 2:If you need to debrief and I have to tell you the number of times that they have reached out students have reached out to me or is not that much? It's not, it's not a burden, it's not that much. But you have tons of students that you're taking right. Like it's a very different setup. I, I really restrict the amount of students that I take so that there's one or two that I'm working with because I want to be able to offer that.
Speaker 2:If I had five students or, like I know, some supervisors who take a ton of students on, like that would be maybe overwhelming, but for me, I, I just I prefer to give like much more attentive attention to like one or two student therapists at a time. So what does that look like for you? Like, are you clear? Are they clear about when when you want them to reach out to you and when they should. You know you're going to invite them to think about it, to to debrief with their colleagues, to write in their supervision journal, to Nope, I don't know, I'm not sure about any of that, I think.
Speaker 2:And oh no, I think those ideas supervision journal.
Speaker 1:I need to purchase those and give them to them Dollar store, but I you know what you're illuminating is the need for there to be a low number, like the ratio of supervisees to supervisor.
Speaker 2:That's my choice. Yeah, I'm not. I'm not going to impose that upon. I see the difference, yeah, but if somebody you know is working in, you know, I know many supervisors who are working in student environments and they have a really good balance. But if I were in my private practice, if I were to take on a lot of students, which I know some do, it looks different. Whereas in a student environment that's the supervisor's role often, and it's not everywhere where they have all these other multiple roles, if you're doing supervision with your students and you're teaching your classes and if, let's say, you're responsible for research, I mean then we work with what we can. There's no perfection. We work with what we can.
Speaker 1:But it matters a lot. How can I be the supervisor I always wanted? And I don't know that you can do that well, and not you, you, michelle, but like we, the collective, I just don't know that we can do it well if we are overburdened by all of the other things. And so I think about my role and how I have not captured my own boundaries enough to be able to do that Right. And so if I think about how can I be the supervisor I always wanted, it would require me to have stronger boundaries around other responsibilities that I take on, but if I want to be that supervisor, I'm going to have to, not and I think so I can just imagine everyone else in your other roles in your life going no, you cannot do this.
Speaker 2:Stop that podcast episode.
Speaker 1:No, but I think in academia, I think this is a thing Folks who are training students, Um, you know, folks who are training students, um you know, are I know colleagues that have upwards of 10 student supervisees and they're like, like, like practicum, you know, like their very first experiences, and at the same.
Speaker 2:At the same time you're working in a system, and when we work in systems, I mean sometimes we could change the system from inside, sometimes there's adaptations we can make, but we're not going to change everything. And part of that system is, yes, you're taking on that student, but there's other things that are happening with that student. There's the practicum course, there's the practicum professor, there's group supervision, there's dyadic supervision. It's not just that one. Sometimes they go to meetings and they see what other people are doing in terms of, like, a group consultation, where people are coming from different domains or different experiences. It's not just students. It could be the students, it could be the clinicians, it could be the therapist, it could be director, sometimes it could be a psychiatrist, you know who comes every now and then and they're talking about cases together. So it's not just the practicum supervisor and I would say that is the important part. Like that, you're part of a team.
Speaker 2:So even when I work with external practices, I will only work with external practices where there really is already an environment of engagement and involvement from the practice site, if it's a practice site. So I'm thinking about a couple of occasions where I declined to move forward and it was a practice site where there wasn't really built-in support, where there wasn't training provided, there was no review of documentation. Right, in one hour a week I'm not gonna be able to do absolutely everything, and so if I align myself with practices who are really focused also on the development of the therapist, then I think that that could be a really positive growth and and doable. But I don't imagine for myself that I could just see, uh, see a student once a week without anything else happening, yeah, and that they're going to get the, the, the support, that they're going to get the support that they need. And in universities you have that structure In theory, we have that structure.
Speaker 1:In theory you have that structure, yes, and because what I was thinking is then the coordination of development of that student requires me to consult regularly with the practicum professor and with their site supervisor and with the site manager. And it's like then when do we have time to coordinate and have ongoing conversation around every student, intern or student supervisee, right? And then there are multiple sites and it's honestly, look, we we're going to need part two because we're already 10 minutes past when we said we were going to stop talking.
Speaker 2:Okay. So one last thing for your, for us, for today. I know there's there's so much more. There's so much, there's so much more. Okay. So maybe one piece we could also just start opening for your listeners be they clients who are just interested in kind of the behind-the-scenes work, be they other supervisors or supervisees to think about is what are some of the challenges that we meet when we're talking about best practice? We could also think, maybe next time, about some of the challenges that we meet when we're talking about best practice. We could also think, maybe next time, about some of the challenges that supervisors meet.
Speaker 2:Yes, and in terms of how can I be the supervisor I always wanted, we talked about, like, showing up what that means, what that looks like. We talked about making an environment where the supervisee is more likely to feel safe and more likely disclose data or information that they feel embarrassed about Yep, feel embarrassed about, more uncomfortable about, and then feedback how do we give feedback? How do we balance? That was it. How do we balance? We've talked about that. You know what I made a note like when to pull back and when to push forward as well, and so I think that that's a piece in terms of how to be the supervisor that I always wanted in thinking about my work with supervisees when to push and when to pull back, when to direct and when to explore and it's such an individual piece in terms of what their readiness stage is, and the readiness stage does not always equate with where they are in the development level. Like you talked about how, when you were initial supervisee, you showed up in kind of this pleasing aspect but I'm sure you were prepared in this and that. So there was a view of you and how you're presenting.
Speaker 2:But they were seeing students maybe beginning and needed different things, and you could meet somebody who's three years into practice or four years into practice and they're not all going to necessarily need the same thing either.
Speaker 2:So really kind of getting to know that supervisee on those levels and moderating ourselves in that. Because when I've talked with supervisees and we could talk more later about some of the things that they really appreciate but some of the challenges that they find have been where supervisees felt that their supervisor was kind of like imposing a modality on them or clinical model on them, that that was just the one way to go, whereas supervisors who they really felt they learned a lot from were ones that had kind of a clear structure but were willing to work with the supervisees on areas of interest of the supervisee, within an ethical context of course. But on the supervisee's interest, maybe their model interest was different, maybe the interventions model, maybe they had different ideas about change model, maybe they had different ideas about change. And as long as the supervisee was being grounded in an ethical practice, an ethical approach, then they could be flexible with the rest and that's something that supervisees have tended to appreciate.
Speaker 1:I wrote a whole list of things we're going to talk about in part two of this. Very excited Everything you just said. I'm like I want to ask Michelle seven questions around when to pull back and when to push forward, and how is supervision different than therapy? And oh yeah, that too. Yes, see what I'm saying, yes, yes.
Speaker 1:Because there's times where, like my supervisees have said, this kind of feels like therapy and I'm like, well, I kind of do have to push you a little bit to figure out where is this bias coming from. And this bias is showing up with your client and so yeah, oh my God.
Speaker 2:We could do an entire-. Yes, yes, yes, yes, the whole thing right, because we need our supervisees to develop the ability to be vulnerable and to bring their vulnerability into sessions in a non-therapy way. We're not being their therapist, but we need that. We need that, they need to be, they need to develop that reflective practice.
Speaker 1:I know it feels like when I'm pushing it's around like bias, work right when it's like well, your bias is that people should work hard. Not everyone believes push like pushing through and working really hard is the way they should solve their problems. And so you keep suggesting these things and so you know, and then they cry like it's therapy and and it's not.
Speaker 2:Anyway, there's a whole lot more to go, how we can help our supervisees develop their vulnerability and non-defensiveness in appropriate ways with us, with their clients and in their external life. Yeah.
Speaker 1:It's really tough because you don't want to cross any boundaries, but you just want them to be good, grown up ethical therapists. At the end of the day, that's the goal. At the end of the day, that sounds the goal.
Speaker 2:At the end of the day, that sounds like the perfect place to end.
Speaker 1:It really does. Okay, michelle, until next time. We're going to do another time on supervision, because there are so many things to unpack here. Any last closing words.
Speaker 2:No, I think we talked about a lot. I think there's a lot more questions and a lot more things to talk about. If any of your therapists or supervisors or supervisees ever want to reach out to me or have dialogues about these kind of things, I love that they could link in with me at LinkedIn. Michelle Manny, m-i-c-h-e-l-e-m-a-n-i, you can connect with me through LinkedIn. You can email me, michellanny, at heytherapistca exactly like it sounds heytherapistca or you can find me on Psychology Today in Canada and just send me a note. Be happy to speak with anyone.
Speaker 1:You're lovely I always leave being like good gracious. There's so much to say and you're so good at it and I want to learn everything from you. So thank you for saying yes to being here listener. Thank you for listening as always, and check out part two. It should be forthcoming very soon, okay, ciao.
